Before you arrive
You will be given a specific admission time. This may be several hours before your surgery time. You will be given very clear fasting instructions, which will be specific to you. You will be asked to use an antiseptic wash the night before and the morning of your surgery.
- Take only the medications you have been instructed to take on the morning of surgery, with a small sip of water.
- Wear loose, comfortable clothing that will fit over a bandage.
- Bring your walking aid if you already use one.
- Leave valuables and jewellery at home.
- Remove nail polish and artificial nails, as these can interfere with monitoring equipment.
Admission
On arrival at the hospital, you will be welcomed by the admissions team and taken to your room or a preoperative area. A nurse will confirm your details, check your vital signs, and review your fasting status and medications. You will be asked to change into a hospital gown and an identification bracelet will be placed on your wrist.
The surgical site will be marked by a member of the team, and you will have the opportunity to ask any final questions. A consent form will be confirmed if it has not already been signed at your consultation.
Hydration
It is important to stay well hydrated prior to your surgery. You can drink clear fluids, including water, Gatorade, apple juice and similar clear drinks, right up until you arrive at the hospital. Once you are admitted, the nursing team will let you know when to stop drinking ahead of your operation.
This updated protocol is known as Sip to Send. Please click on this link for more information from the Australian and New Zealand College of Anaesthetists guideline on Sip to Send.
Meeting the anaesthetist
Your anaesthetist will visit you before surgery to review your medical history, discuss the anaesthetic plan, and answer any questions. Hip and knee replacement are most commonly performed under a spinal anaesthetic with sedation. With a spinal, a single injection in the lower back numbs the lower half of the body, and sedation is given so that you are drowsy or asleep throughout.
In some cases a general anaesthetic is used instead. The anaesthetist will explain which approach is most appropriate for you and why. Local anaesthetic is also infiltrated around the joint during the procedure as part of a multimodal pain management plan.
In the operating theatre
When it is time for your operation, you will be walked or taken on a bed to the operating theatre. The theatre is cooler than the ward, and you may notice bright lights and equipment. The anaesthetist and nursing staff will stay with you throughout.
The operation itself typically takes around an hour, though this varies with anatomy and complexity. Including preparation, anaesthesia and recovery, the total time from leaving the ward to returning is usually several hours.
The recovery room
After the operation, you will be taken to the recovery room, where specially trained nurses monitor you as the anaesthetic wears off. You will have a drip in your arm for fluids and pain medication, and your vital signs will be checked regularly.
Once you are stable and comfortable, you will be transferred to the ward. Your family will be notified that the operation is complete and that you are in recovery.
Your first steps
Most people are helped to stand and take a few steps on the day of surgery or the following morning, with a physiotherapist and a walking aid. Weight-bearing is generally permitted immediately. This early mobilisation reduces the risk of blood clots and stiffness and is an important part of the recovery process.
Questions to ask
- What time should I arrive at the hospital?
- Which of my morning medications should I take, and which should I skip?
- How long will I be in the operating theatre?
- When will my family be able to see me after surgery?
- Will I be in pain when I wake up?
Common questions
How long will I be in hospital on the day of surgery?
Most patients stay in hospital for one to three days after a hip or knee replacement. On the day of surgery, you will spend time in the operating theatre and then in the recovery room before returning to the ward. The total time from arrival to being settled on the ward is usually most of the day.
Will I be awake during the surgery?
Hip and knee replacement are most commonly performed under a spinal anaesthetic with sedation. This means the lower half of your body is numbed and you are given sedation so that you are drowsy or asleep. You will not feel the operation. Some patients have a general anaesthetic instead, and the anaesthetist will discuss which is most appropriate for you.
When can my family visit?
Visiting is usually possible once you have returned to the ward from the recovery room. The nursing staff will let your family know when you are settled. On the day of surgery, brief visits are usually preferred as you will be resting.
Will I be in a lot of pain afterwards?
Pain is managed with a combination of medications, local anaesthetic given during surgery, and early mobilisation. Most people describe significant discomfort for the first day or two, which then steadily improves. The arthritic pain you had before surgery is usually gone immediately, replaced by surgical soreness that settles over several weeks.
Will I walk on the same day as surgery?
In most cases, yes. Patients are helped to stand and take a few steps with a physiotherapist and a walking aid on the day of surgery or the following morning. Weight-bearing is generally permitted immediately. This early mobilisation is an important part of recovery.
Common questions.
What time will I be admitted?
Usually early, often before six in the morning, and the hospital confirms the time with you. Being admitted early does not mean operating early; the list order is set the day before and can change.
How long is the operation itself?
A straightforward hip or knee replacement takes roughly one to two hours of theatre time. You will be away from the ward considerably longer than that, because anaesthetic preparation and recovery either side both take time. Tell your family to expect three to four hours before they hear anything.
Will I be awake?
That is decided with your anaesthetist. Both operations can be done under spinal anaesthetic with sedation, where you are asleep but not under a general, or under a general anaesthetic. Spinal is often preferred in older patients.
Why does everyone keep asking me the same questions?
Your name, date of birth, procedure and operative side are confirmed repeatedly by different people, and the site is marked on your skin while you are awake and agreeing with it. That repetition is the surgical safety checklist working. It is not disorganisation.
Will I walk on the day of surgery?
Almost always, yes, with aids and a physiotherapist beside you. It is one of the single most useful things for your recovery and it is not as hard as it sounds.
When will my family hear anything?
Professor Rodda or the ward will make contact once you are safely in recovery. Ask your family to be patient in the first few hours; no news on the day of surgery is ordinary rather than ominous.
This page provides general information about a medical condition and a surgical procedure. It is not individual medical advice and does not replace consultation with a qualified practitioner. Outcomes vary between individuals and all surgery carries risk. A referral is needed for a consultation with Professor Daevyd Rodda; without one, you can start with the practice nurse practitioner, who can provide it.